Vaccination has been recognized as one of the greatest U.S. public health achievements of the 20th century. However, implementation of new and established vaccines can pose significant challenges. Primary care providers play a central role in the process of immunization delivery and are, therefore, a critical source of information about the feasibility and acceptability of new or changing vaccination recommendations. In the current application we describe a multidisciplinary study team with the experience and expertise to rapidly design, conduct and analyze surveys of providers in order to respond to issues relevant to immunization delivery policy. The proposed study team has extensive experience in conducting mail, e-mail, telephone and mixed-modality surveys and in qualitative methods, should they be required. In addition, during four previous projects, the study team developed an innovative methodology of conducting rapid turnaround (within 8 weeks) policy-relevant surveys using networks of sentinel providers in four primary care specialties (pediatrics, general internal medicine, family medicine and obstetrics/gynecology), recruited to be representative of the relevant national organization for each specialty. In the current proposal we propose using this methodology to create sentinel physician networks in the four primary care specialties and, if needed, in other specialties including public health, pharmacy or nursing. We will conduct a minimum of three provider surveys per year with high response rates and will plan to have preliminary data to CDC within 8 weeks after initiation of each survey protocol. We will use a previously successful process for collaborating with the CDC in the design and refinement of surveys and a mechanism for eliciting input regarding important policy issues from two national groups of advisors, a vaccine delivery expert advisory committee and a community advisory committee. We plan to disseminate findings of our surveys and qualitative studies through presentations at ACIP meetings and through publications of manuscripts jointly with CDC collaborators. The study team will work collaboratively with the CDC in the areas of highest priority to the current proposal, including input to inform recommendations for new vaccines, strategies to improve immunization coverage, vaccine financing issues, barriers to the interface of immunization information systems (IISs) with electronic health records or their use by providers to document vaccines for patients of all ages, and developing contingency plans to address urgent problems, such as vaccine supply shortages, vaccine safety issues or pandemic disease. Such data will assist the CDC in making immunization policy recommendations and will inform efforts to create educational and outreach materials for providers and patients.
Primary care providers deliver the majority of vaccines in this country and are a critical source of information regarding the feasibility and acceptability of new or changing vaccination recommendations. This project will provide a mechanism for obtaining rapid turnaround information about provider knowledge, attitudes and beliefs regarding immunization challenges on a national level. These data will be presented at ACIP meetings and will assist the CDC in making policy recommendations about new vaccines, in developing strategies to improve vaccination coverage and in planning for urgent immunization problems that arise, such as vaccine supply shortages or vaccine safety issues.
